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Individual

DR. ERIC EUGENE SANTOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 E 1ST ST, ST MARGARET'S HOSPITAL/DEPARTMENT OF PATHOLOGY, SPRING VALLEY, IL 61362-1512
(815) 664-1470
(815) 664-1141
Mailing address
PO BOX 809059, CHICAGO, IL 60680-9059
(888) 843-8475
(314) 849-6395

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036.117681
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036.117681
IL STATE LICENSE NUMBER
IL
01
1114110780
GROUP NPI
IL
01
14D0431111
CLIA
IL
01
215550
MEDICARE GROUP NUMBER
IL
01
615604
BSCHI
IL
Enumeration date
05/09/2007
Last updated
05/02/2008
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